What the study found
The study found updated reference ranges for pediatric liver size on ultrasound, based on age and height. The authors report that the normal liver size range is slightly higher than previously reported.
Why the authors say this matters
The authors say the work matters because liver size assessment is a basic part of pediatric abdominal imaging, and they argue that newer, more rigorous reference ranges are needed. The study suggests these updated nomograms could support more contemporary assessment of normal liver size in children.
What the researchers tested
The researchers reviewed radiology reports from January 2014 to December 2024 for patients under 18 years old who had a "normal abdominal ultrasound" impression. They excluded patients with liver disease or abnormal AST and ALT results, and used generalized additive models for location, scale, and shape (GAMLSS) with a Box-Cox power exponential distribution to build reference ranges from age and height.
What worked and what didn't
A total of 4,611 ultrasound examinations met the study criteria, including 2,055 males and 2,556 females. Liver size ranged from 4.9 to 5.5 cm at birth and increased with age to 17.2 cm in adolescents aged 17-18 years; in the 3,235 exams with recorded height, the pattern increased more linearly with height and reached 17.5 cm at 180 cm tall.
What to keep in mind
The summary does not describe any major limitations beyond the retrospective design and the fact that height was available for only 70% of examinations. The reported ranges are based on one institution's ultrasound measurement standard and on children whose studies were interpreted as normal and who did not have abnormal AST or ALT results.
Key points
- The study created updated pediatric liver size reference ranges on ultrasound.
- The authors say the normal liver size is slightly higher than earlier reports.
- Age-based ranges showed liver size increasing from 4.9-5.5 cm at birth to 17.2 cm at ages 17-18 years.
- Height-based modeling used 3,235 examinations and showed a more linear increase in liver size with height.
- Reference ranges were reported up to 180 cm in height, with a maximum liver size of 17.5 cm.
Disclosure
- Research title:
- Updated pediatric liver size ranges on ultrasound
- Authors:
- Amirreza Manteghinejad, Marcus Meneses, Julian López Rippe, Erica L. Riedesel, Summer L. Kaplan
- Institutions:
- Children's Hospital of Philadelphia, Children's Hospital of Philadelphia, Children's Hospital of Philadelphia, Children's Hospital of Philadelphia, Children's Hospital of Philadelphia, Philadelphia University, Philadelphia University, University of Pennsylvania, University of Pennsylvania
- Publication date:
- 2026-04-24
- OpenAlex record:
- View
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